Numerous publications and patent documents, including both published applications and issued patents, are cited throughout the specification in order to describe the state of the art to which this invention pertains. Each of these citations is incorporated herein by reference as though set forth in full.
Neuromyelitis optica spectrum disorders (NMOSD) include limited forms of Devic's disease, such as single or recurrent events of longitudinally extensive transverse myelitis, bilateral simultaneous or recurrent optic neuritis, asian optic-spinal multiple sclerosis, optic neuritis associated with systemic autoimmune disease, optic neuritis or transverse myelitis associated with lesions in specific brain areas such as the hypothalamus, periventricular nucleus, and brainstem, and NMO-IgG negative NMO: AQP4 antibody-seronegative NMO.
Neuromyelitis optica (NMO or Devic's disease) is an inflammatory, demyelinating syndrome of the central nervous system that is characterized by severe attacks of optic neuritis and transverse myelitis, which, unlike the attacks in multiple sclerosis, commonly spare the brain in the early stages.
In developed nations, neuromyelitis optica disproportionately strikes non-white populations, in which multiple sclerosis is rare. Neuromyelitis optica presents with clinical, neuroimaging, and laboratory findings that distinguish it from multiple sclerosis. Moreover, the detection of neuromyelitis optica immunoglobulin G (NMO-IgG), an autoantibody, in the serum of patients with neuromyelitis optica, distinguishes neuromyelitis optica from other demyelinating disorders. NMO-IgG binds to aquaporin 4 which is the main channel that regulates water homoeostasis in the central nervous system. NMO-IgG is also detected in the serum of patients with disorders related to neuromyelitis optica, including Asian optic-spinal multiple sclerosis, recurrent transverse myelitis associated with longitudinally extensive spinal cord lesions, recurrent isolated optic neuritis, and optic neuritis or transverse myelitis in the context of certain organ-specific and non-organ-specific autoimmune diseases.
NMO patients are currently treated using agents which reduce symptoms and reduce or prevent relapses. No cure for NMO or NMOSDs is currently available. Most individuals with NMO have an upredictable, relapsing course of disease with attacks occurring months or years apart. Disability is cumulative, the result of each attach damaging new areas of myelin. Clearly, a need exists for improved treatments for this devastating disease which can limit the neurologic dysfunction that results from successive acute relapses of NMO.